13 May 2009

I go to the cafeteria to get some breakfast. I come back, and there is a new patient in room three. There are four police officers in the hall, laughing and having a great time. "You're gonna love this one, doc!"

Uh Oh.

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Updated by popular demand:

Turns out it was a drunken psychotic patient, covered with his own various bodily fluids. He had been living under a bridge and his hygiene was as poor as you might expect. He had been picked up for disorderly conduct, and was brought to us for a psych eval.

BUT - and this is key - he had an outstanding FELONY warrant! So the cops had to take him to jail. One quick medical screening exam later, the guy is back in the squad car and off to jail.

I made a lot of friends today. The nurses were delighted that I didn't insist on blood tests, a banana bag and a psych eval in the ED. The cops were delighted that they didn't have to hang out and guard him for several hours. He was eminently medically stable for jail (where psych and detox evals are also available). The nurses were so happy that I didn't do the million-dollar CYA work-up that they went out and bought me Starbucks!

we had one of those psych cases last night. brought in by the cops and family, cleared medically, and transferred to inpatient psych...we thought we were home free...until 40 mins later we get a call from the psych hospital saying that the water main broke, flooding the facility, and they were sending us the patient back.

As the drama ensued, we found out they emptied the psych hospital into local ED's. Thank god I work on the other side of town.

Shadowfax

About me: I am an ER physician and administrator living in the Pacific Northwest. I live with my wife and four kids. Various other interests include Shorin-ryu karate, general aviation, Irish music, Apple computers, and progressive politics. My kids do their best to ensure that I have little time to pursue these hobbies.

Disclaimer

This blog is for general discussion, education, entertainment and amusement. Nothing written here constitutes medical advice nor are any hypothetical cases discussed intended to be construed as medical advice. Please do not contact me with specific medical questions or concerns. All clinical cases on this blog are presented for educational or general interest purposes and every attempt has been made to ensure that patient confidentiality and HIPAA are respected. All cases are fictionalized, either in part or in whole, depending on how much I needed to embellish to make it a good story to protect patient privacy.

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